Why does chronic stress cause some people to break out in hives? Most scientists agree that stress-induced hives, also known as chronic idiopathic urticaria, are caused by an allergic-type reaction that persistent stress can trigger in the human body. Chronic idiopathic urticaria is the most common type of hive, albeit the most perplexing for scientists to study, because individual reactions to stress are so variable. Stress tolerance varies immensely from person to person and is often context specific; therefore, it is difficult to examine scientifically in repeatable experiments. As such, it is unsurprising that the medical community has been reluctant to fully embrace this hazy explanation for the condition, despite the large body of evidence demonstrating the link between hives and chronic stress.

The skin is the largest organ in our body, and is extremely sensitive to stimulus. Some scientists studying the link between stress and hives have posited the theory that exposure to continual stress upends the balance of our internal chemistry, causing the body to produce large quantities of the hormone cortisol. Cortisol is a corticosteroid hormone produced by the adrenal gland, and in normal quantities helps the body regulate proper glucose metabolism, blood pressure, insulin release, immune function and inflammatory response.

Despite the key role that this hormone plays in regulating homeostasis in the body, cortisol is also known as the “stress hormone,” because the adrenal gland secretes large quantities of cortisol into the blood stream in response to stress or anxiety as part of our “fight or flight” response. Thus, normal amounts of cortisol can be beneficial for our bodies: it provides a jolt of energy in crisis situations; temporarily improves memory function and immunity; lowers pain sensitivity and helps maintain equilibrium in the body. However, if the adrenal gland continually secretes cortisol into the blood stream in response to persistent stress, this hormone can cause of host of harmful effects, including elevated blood pressure, blood sugar imbalances and increased abdominal fat (thus inspiring the invention of the dubious diet supplement “Relacore”). Large quantities of cortisol also notably decrease immune and inflammatory responses in the body, which may help explain how chronic stress can trigger hives.

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